JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

Stress radiographs after ankle fracture: the effect of ankle position and deltoid ligament status on medial clear space measurements.

OBJECTIVE: This study was designed to determine 1) how ankle position affects the medial clear space by using stress radiographs, 2) which medial clear space measurement, overall width or increase in width, better predicts deep deltoid ligament disruption after Weber type-B distal fibular fracture, and 3) what value of medial clear space is most predictive of deep deltoid ligament disruption after Weber type-B distal fibular fracture.

DESIGN: Cadaveric fracture model.

SETTING: Biomechanics laboratory.

INTERVENTION: Fluoroscopic mortise views were taken of 6 fresh cadaveric ankles mounted in a fixture permitting both positioning in neutral flexion, dorsiflexion, and plantarflexion, and the application of internal and external rotational forces. After destabilizing the ankles according to the supination-external rotation mechanism of Lauge-Hansen, repeat radiographs were taken with the same combination of flexion and applied rotational stress.

MAIN OUTCOME MEASURE: Radiographic measurements of medial clear space width and changes in medial clear space were made.

RESULTS: A medial clear space of > or =5 mm on radiographs taken in dorsiflexion with an external rotational stress was most predictive of deep deltoid ligament transection after distal fibular fracture. In dorsiflexion-external rotation, medial clear spaces of > or =4 mm yielded lower specificity and positive predictive value, whereas > or =6 mm yielded lower sensitivity and negative predictive value. All other stress conditions and increases in medial clear space of 2 or 3 mm were less predictive.

CONCLUSIONS: Ankle stress radiographs taken in dorsiflexion-external rotation were most predictive of deep deltoid ligament disruption after distal fibular fracture. Under this stress condition, a medial clear space of > or =5 mm was the most reliable predictor of deep deltoid ligament status.

Full text links

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app